Please give the names of three persons not related to you, whom you have known at least one year

Please read the statement below carefully and sign.
I certify that all information on this application is true and correct. I also certify that I have accounted for all my work experience and training on this application.

DISCLOSURE AUTHORIZATION FORM

In signing this application for employment, I state that in completing this application for employment form, all of my responses are true to the best of my knowledge. I understand that by accepting this application, neither Mast Trucking (“the company”) nor any of its employees have made any expressed or implied offers of employment. I understand and agree that, if hired, my employment is for no definite period and may be terminated at any time without any prior notice. In connection with my application for employment, I understand that investigative background inquires may be conducted concerning myself including criminal, educational, employment, and personal references. These reports may include information as to my character, general reputation, personal characteristics, work habits, performance, and work experience along with reasons for termination of past employment from previous employers. Further, I understand that the company may be requesting information from various governmental agencies that maintain records concerning any criminal record. I hereby unconditionally release the
company and all parties supplying such information from all liability that might result from furnishing this information, or its use. I authorize, without reservation, any party or agency contracted by the company or its agent to furnish the above mentioned information.

In the event of employment, I understand that false or misleading information given in my application or interview(s) may result in discharge, and that I will be required to abide by all rules and regulations of the company.

Any offer of employment is contingent upon a negative drug screen.